NEURO 7 Flashcards
myotonic dystrophy genetics
symptoms
ADom
myotonia, weakens, cataracts, frontal balding, ptosis, cardiac
MULTISYSTEM INVOLVEMENT
rhabdo is what
leads to what
ix
rx
breakdown of skillets muscle
AKI, black pee
AKI, increased Cr, decreased Ca, increased Phos
IV fluids
curare does what
occupies same position on Acc receptors but doesn’t open ion channel - no muscle contraction - no respiration
MG is what
symptoms
ix
post synaptic disease
prox limb weakness worse throughout day, swallowing, eyes
AcH antibodies, anti muscle specific tyrosine kinase ABs
CT - thorax for thymoma, CK is normal
treatment of MG acute and non acute
acute plasmapheresis/immunoglobulin
pyridostigmine, pred and aza
thyrectomy
botulism is what
who
symptoms
pre synaptic. IVDU. black tar heroin
rapid onset weakness without sensory loss
LE syn is what
related to what
symptoms
rx
pre synaptic. ABs to calcium - less vesicle release
SCLC
limb girdle weakness - lower limbs first - muscles get better throughout the day
immunosuppression
migraine with aura or without aura is more common
without
only 15-33 with aura
migraine criteria how many attacks
lasting how long
2 of what:
1 of what:
at least 5 lasting 4-72 hours
2 of: malaise, unilateral, throbbing pain. worse on movement
1 of: autonomic features photophobia/phonophobia/nausea or vom
what are the different types of aura and which is the commonest one
visual, sensory, motor, language
visual commonest
how long does an aura last and when does it occur in relation to the headache
20-60 mins full reversible
headache less than 1h later but can be simultaneously
when should imaging be done in patients who present with migraine
>50 and new onset headache known malignancy immunosuppressed early morning headache exacerbated by valsava
acute management of migraine
aspirin 900mg or
ibobrufen 400mg-900mg or
sumatriptan 50-100mg +/- naproxen 500mg
second line management of acute migraines
cautions of this drug
metoclopiramide
leads to extra pyramidal side effects
acute migraine with nausea and vomitng
metaclopiramide or prochlorperazine
what are triptans contraindicated in
ishcaemic heart disease
criteria for giving prophylaxis for migraines
how long should the trial of proph be
> 3 per month
4m
prophylaxis 1.
2.
3.
4.
propanolol PO OD or Topirimate 25-100mg
amitriptyline
candesartan
Na Val
period migraines
frovatriptan/zoimetriptan daily PO
pregnancy and migraines 1
2
when can these be given
1 paracetamol 1g
2 aspirin 300mg/ibobrufen 400mg
in first/second trimester
who do clusters happen in and when
M 30-40yo around sleep
symptoms of clusters
restlessness
severe unilateral headache
1-8 per day
how long do clusters last and how long can the interval be between bouts of clusters
weeks to months
interval can be up to a year
acute treatment of cluster headache
prophylactic treatment
high flow oxygen for 20 mins and subcut somatotriptan 6mg. steroids that are decreased in dose over 2w
proph verapamil or pred
paroxysmal hemicronia in who
elderly 50-60yo women
difference between PH and clusters
10-30mins and 1-4/day
treatment of PH
indomethan
SUNCT
short lived 15-20s unilateral neuralgia form headache conjunctival infections tearing
treatment of SUNCT
lamotrigene
gabapentin
trigeminal neuralgia in who
triggered by what
> 60s W>M
triggered by touch and usually V2/V3
ix in TN and why
MRI
atypical features, poor response to medical treatment or surgery being considered
treatment of TN
carbamazapine
gabapentin. phenytoin. baclofen
surgical treatment of TN
ablation/decompression
tension headache features
bilatera l tight band of mod-severe intensity around head
can radiate to neck
are tension headaches aggravated by exercise
no
treatment of tension headaches acute and proph
aspirin and paracetamol
amitrip
what counts as a chronic daily headache
headache daily for 15 or over days in a month for 3 months
causes of chronic daily headache
medication overuse
opiod meds or overusing triptans
